Individual
JARED YOUNG ROBERTSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4200 HOUMA BLVD FL 6, METAIRIE, LA 70006-2970
(504) 503-4331
(504) 503-4341
Mailing address
4200 HOUMA BLVD, MEDICAL STAFF SERVICES, METAIRIE, LA 70006-2970
(504) 503-6781
(504) 503-5667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
330711
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/18/2019
Last updated
07/22/2022
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